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This week's message:

Next shop opening is Monday, April 20, 2015, at 11 am Eastern time. Because my kids' April break stars the following week, this opening will be for a limited number of in-stock slings only. That way, I can finish sewing before their break and have some time to spend with them. The next all-inclusive opening (for in-stocks and WCRS) will be Monday, May 4, at 2pm Eastern time.
I expect turnaround for orders placed on March 23 to be in the 4-9 business day range.
(NB: Slings labeled in-stock are still sewn to order -- it's the fabric that I have in stock, not finished slings, and slings are not sewn until orders are placed.)

I always post regular updates about the precise time I will reopen the store on my Facebook page. If you "like" my page on Facebook you can get them easily, and if you select "get notifications", Facebook will tell you when I post, which is the best way to get reminders. Otherwise, you can always refresh the home page here and check the Facebook feed below to see what I've posted.

While the store is closed, the "add to cart" button has been removed to keep new orders from being placed.

Newborn and infant safety

Key points:

Car seats are for use to secure an infant when riding in a car. They are
less safe than a baby carrier when used outside their intended purpose as car
safety devices.

Infants are safer in their caregivers' arms than left in a device (car seat,
stroller, bouncy seat, crib, swing, etc.).

It is vital that caregivers be aware of their infant's breathing at
all times.

It's okay to wake the baby to take him out of the car
seat. Deep sleep is
a dangerous time for infants; SIDS invariably occurs during deep sleep, and other
breathing difficulties are also a greater risk during deep sleep.

Infants should always be visible and kissable in a carrier.

Any carrier should hold the baby the way you would hold
the baby in arms.

In the last 15 years, much has been learned about keeping newborns and infants
under 4 months safe. The “back to sleep” campaign is responsible
for a considerable reduction in SIDS and related deaths, for example. However,
there is a great deal of research into infant physiology that still has not filtered
into either popular knowledge or product design.

In 1995, a study was done on infants’ oxygenation levels in their car seats.
Normal oxygenation levels – that is, the amount of oxygen circulating in
the blood stream attached to red blood cells – range between 97-99% in
a healthy term infant in optimal positioning. Any oxygenation level below about
90% is considered “hypoxia” – the baby is not receiving enough
oxygen, and brain damage can result if that level is sustained. Shockingly, healthy,
full-term newborns placed in correctly positioned car seats had oxygen levels
that went as low as 83.7%. In the hospital, such levels would bring teams of
nurses scrambling to the infant’s rescue. While not all infants’ oxygenation
levels reached such depths, there was a consistent finding that the longer the
baby spent in the car seat, the lower their oxygen levels would go, until the
baby was removed from the seat.

The study was repeated in 2005, with the same results. The conclusion in
both studies was that babies should spend the least amount of time possible in
a car seat, and they recommended that car trips with new babies be kept to an
hour or less, and that infant car seats be used only in the car, and not beyond
that. And
yet, these studies and others like them have gone almost completely unnoticed
in the United States and Canada, and it’s not uncommon to see infants in
car seats for hours on end, being moved from the car to a travel system to home
without ever being removed from the seat. How much damage is being done to these
infants while they seem to sleep so peacefully?

Hypoxia is known to cause damage to the developing brain. Infants who experience
hypoxia will show more signs of ADHD, decreased IQ, delayed motor development,
and impaired attention. If these conditions sound familiar, perhaps we are beginning
to understand why, as more and more children spend their infancies in some form
of baby seat, reclined and in a hypoxic state.

In addition to the hypoxia seen in healthy, full-term newborns, there is
also a risk due to positional asphyxia. This unfortunately is not an uncommon
cause of death in infant car seats. A newborn baby’s head is very heavy, and
its neck is quite fragile in comparison. Newborns, especially but not exclusively
those born prematurely or with respiratory issues, are prone to having their
heads tip forward onto their chests, drastically narrowing the airway (which
is about the width of a drinking straw) and blocking proper flow of air. This
can cause hypoxia and even death, and is a risk in any baby containment device
that places the infant in a seated position, including (but not limited to) car
seats, baby swings, bouncy seats, and yes, even cloth slings, if the parent doesn’t
follow positioning guidelines.

So, what do we do about this?

Knowledge is key.

Every parent and caregiver *must* be aware of their baby’s
position and breathing at all times. Let me repeat that. Every parent and
caregiver must be aware of their baby’s position and breathing at all times. Whether
the baby is in a car seat, a sling, or even in the caregiver’s arms, he
or she must keep an eye on the baby’s respiration and positioning. (This
does mean that if you have a newborn and you must take a long car trip, it is
best for one caregiver to sit in the back with the baby whenever possible, and
stop frequently to allow the baby to recover from hypoxic episodes, which grow
more severe and numerous the longer the infant is in the seat.)

In a carrier, an upright, chest-to-chest position is best with newborns and
infants under 4 months. In this position, the baby is aware of the caregiver's
breathing patterns and vice-versa. (Human infants are programmed to take breathing
cues from their parents, and often an abnormal breathing pattern is noticed subconsciously
by the parent, who then rubs the baby's back, bounces, or sways, all of which
will help reorganize the baby's breathing.) The caregiver is able to keep the
infant's head in an optimal position, usually turned to one side, and this position
is one that adults often adopt when holding a newborn without a carrier -- always
a good sign that the position is a physiologically healthy one.

When a carrier is used to recline an infant in what we consider a cradle
hold, it is vitally important that the baby's head still be in easy view of the
parent, and close enough to kiss. The baby's neck should be straight down to
his pelvis, and while it is okay for the spine and legs to curve gently (because
infants are naturally curled up), it should never be at a more extreme angle
than one would see with the baby held in arms. In any carrier, a good test of
whether it is correctly positioned is to bring one's arms up around the baby
in the carrier as though it weren't there. If there is significant movement,
then the carrier needs to be adjusted so that they mimic an in-arms position
as much as possible.

It should be clear by now that "bag sling" style carriers (those
with a hard bottom, and curved and elasticized tops) are never a good choice
for carrying a newborn. The flat bottom tends to allow the infant to roll towards
the parent (and this occurs even with an internal harness), creating
a risk of suffocation, while the shape of the carrier forces the infant's head
onto his chest. In addition, the closed top keeps the baby from being seen, so
that if hypoxia does occur, the parent misses the signs, often until it's too
late, and because the baby is so deep in the carrier, he is also at an increased
risk of rebreathing carbon dioxide. The "bag sling" is really a perfect
storm of hypoxia causes, and it should come as no surprise that the majority
of "sling" deaths
have occurred in this style of carrier.

Other safety considerations in baby carriers:

Any item that is made of fabric and that is used regularly is going to wear
out some day, whether it's a favorite toy, blankie, cloth diaper, or carrier.
This is also true of cloth baby carriers; there is no magic in a fabric when
it's made into a carrier that keeps it from wearing out with use. All fabrics
take a beating when they are weight-bearing, and when they are washed and dried
repeatedly, the fibers will start to break down with time. For thick and sturdy
fabrics, this may take years of heavy use, but for fabrics that are appropriate
for slings and wraps, it make take less time, because the fiber threads tend
to be thinner.

When using a sling, whether it's brand-new or a hand-me-down, please be sure
to look over the entire length on a regular basis (such as after it's been washed
and dried, or before you thread or put it on) to check for weak spots in the
fabric. This would include areas where the fabric is pilly, where the surface
appears fuzzy, or where you can see broken threads in the weave. Any carrier
that has holes in it should be used with extreme caution, or preferably not at
all, since a hole can easily develop into a full-blown tear with stress (such
as when the sling is adjusted through the rings, or when a wrap is tightened).
A well-loved carrier often has a lot of sentimental value, but it's better to
use it for a blanket or child's lovie than to continue using it as a carrier
after it shows signs of wear.

Conclusions:

It is not my intention in sharing this information to terrify
parents. We do have enough to worry about as it is. However, the media seems
very quick to jump on baby slings as the hazard of the week, while ignoring the
very real hazards of leaving infants in their car seats and other such devices.
The studies on infant car seats and hypoxia (below) all come to the same conclusion:
leave the car seat in the car. While manufacturers have made it easier than ever
to go through a whole day with the baby in the car seat (including travel systems
and snap-on stroller bases), they are not doing so based on the available research
(and why should they, when it would hurt their bottom line?).

Parents often assume that since a baby product is sold in a store, it must
have been tested, but that really isn't true. Some products are, but the vast
majority are not, as can easily be seen by the number of recalls that occur each
year. Consider the number of cribs that are recalled each year, including finally
the whole drop-side crib category. Had they been rigorously tested, the recalls
never would have been necessary, but infant products, like most others, are primarily "tested" by
the public after they are released. There have been far, far more deaths in car
seats, bath seats (the number one in terms of infant deaths per unit used), strollers,
cribs, bouncers, and swings than in slings and other carriers, but you'd never
know it from the way they were marketed and reported on.

Finally, a little fear
can be healthy at times. If worrying about a baby's breathing makes the caregiver
check him more often when he's in some kind of baby holding device, that's much
better than just assuming he's safe and not checking frequently. Infants are
on the whole remarkably resiliant (there are nearly seven billion of us on the
planet, after all), but physiologically, we were not made to lie in plastic containers
all day. Human infants thrive on touch, motion, and closeness with their caregivers,
and it would be misleading to say that being held is "beneficial" to babies
and their caregivers: it is simply what we are wired to do, and anything else
is actually detrimental. A good baby carrier allows caregivers to fulfill their
babies' needs and still go about their daily tasks with ease, and that is the
real benefit.

Acknowledgments:

This article would not have been possible without M'Liss Stelzer, RN, who
brought these issues to the attention of the babywearing world way back in 2006.
Her presentation at the 2010 International Babywearing Conference was excellent,
and I hope to see it online soon. Until then, I wanted to make sure the information
was out there in some form, and she inspired me to write this and see how widely
it can be disseminated.